How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $407.38 Median $1,380.38 Typical High $5,623.41 | Facility | None | $407.38 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | None | $371.54 | $407.38 | $446.68 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $5,248.07 | Facility | None | $1,318.26 | $2,041.74 | $5,248.07 |
BCBS Illinois Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $954.99 | Professional | None | $489.78 | $660.69 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $1,949.84 | Facility | None | $478.63 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $776.25 | Professional | None | $426.58 | $512.86 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,380.38 | Professional | None | $446.68 | $660.69 | $1,380.38 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $616.60 | Professional | None | $478.63 | $512.86 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $562.34 | Professional | None | $33.11 | $54.95 | $562.34 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $2,818.38 | Facility | None | $141.25 | $501.19 | $2,818.38 |
United Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $812.83 | Professional | None | $371.54 | $446.68 | $812.83 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $74.13 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Where Illinois sits
The same service costs 5.4 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Illinois· 31st of 51
$501
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.